The Depression Interview and Structured Hamilton (DISH): rationale, development, characteristics, and clinical...

Area of Science:

• Psychiatry
• Clinical Psychology
• Cardiology

Background:

• Depression is prevalent in patients with acute myocardial infarction.
• Accurate depression assessment is crucial for effective treatment in cardiac patients.
• The Enhancing Recovery in Coronary Heart Disease (ENRICHD) study required a reliable depression assessment tool.

Purpose of the Study:

• To describe the development and characteristics of the Depression Interview and Structured Hamilton (DISH).
• To present a validity study of the DISH in medically ill patients.
• To report on the DISH's utility within the ENRICHD study.

Main Methods:

• The DISH was developed as a semistructured interview for diagnosing depression and assessing severity.
• A validity study compared DISH diagnoses with the Structured Clinical Interview for DSM-IV (SCID).
• The Beck Depression Inventory (BDI) and Hamilton depression scores were used for correlation analysis.

Main Results:

• The DISH demonstrated high agreement with SCID diagnoses (88%, kappa = 0.86).
• Clinician agreement with DISH diagnoses in the ENRICHD study was 93%.
• Significant correlations were found between DISH-derived Hamilton scores and BDI scores (r = 0.76 and 0.64).

Conclusions:

• The DISH is a valid and reliable semistructured interview for assessing depression in medically ill populations.
• The DISH efficiently provides both a DSM-IV depression diagnosis and a 17-item Hamilton depression score.
• The DISH is suitable for use in clinical trials like ENRICHD involving cardiac patients.